Abdominal Hematoma Following an Auto Accident
I’m Ed Smith, a Sacramento Personal Injury Lawyer. A car accident is a legitimate risk whenever someone gets behind the wheel of a motor vehicle and injuries have the potential to occur from even the smallest of fender benders. The severity of injuries following a car accident can encompass a wide range, with some being more severe than others. A recent case report described an unusual presentation of an abdominal hematoma that was not discovered until months after a car accident with serious consequences for the patient and their loved ones.What is an Abdominal Hematoma?
When patients are involved in a car accident, a variety of traumatic injuries can occur. Some of these injuries can result from abdominal trauma from another vehicle, damage to the driver's car, or even from improper use of a seat belt. There are numerous organs in the abdomen, such as the liver, spleen, and stomach, that might be injured in a car accident. While many patients are concerned with bleeding into the external environment (and rightly so), it is also possible to bleed internally. The abdomen is a large cavity that can hold multiple liters of blood. Therefore, it is possible for patients to bleed to death if they are losing blood into their abdominal cavity. If blood starts to leak out from the blood vessels into an abdominal organ or wall of the abdomen itself, it can form a pocket. This pocket of blood is termed an abdominal hematoma and must be diagnosed and treated quickly before a patient can lose too much blood. Sometimes, an abdominal hematoma can be missed, leading to dire consequences for the patient. A recent case of a delayed abdominal hematoma development and diagnosis following an auto accident was published in the medical literature.Involved in a Car Accident
The patient described in the case report was a middle-aged female who was involved in a car accident. The accident was serious enough for the patient to be hospitalized with multiple injuries. She underwent a procedure called an exploratory laparotomy which is used to diagnose and treat injuries that are causing serious symptoms but may not be visible on imaging or to the naked eye. During this procedure, she was diagnosed with a hematoma. This injury was treated with fluid resuscitation and rest, the proper treatment for a hematoma that isn't significant in size or growth. The patient was then discharged home with instructions to avoid strenuous activity until the symptoms subsided. The patient was also instructed to follow-up if the symptoms worsened or changed significantly in any way.A Visit to the ER
Around five months later, the patient returned to the emergency department with complaints of swelling in her groin region. The symptoms were similar to that of an inguinal hernia, where an organ or loop of bowel protrudes from the lining of the pelvis. This can be a serious injury if the bowel is constricted by the fascia of the pelvis because this can lead to necrosis and death of the tissue. When the patient had a physical exam completed in the ER, the team decided to order an MRI to get a better look at what was happening in the suspected hernia location. To the surprise of the medical team, the MRI revealed a significant abdominal hematoma that was likely the growth of the earlier abdominal hematoma that was not completely treated. The patient was taken to the operating room for treatment of her abdominal hematoma, which was identified to be free blood that had not yet clotted. Fortunately, the swelling was not large enough for the patient to bleed to death. The patient did well after the operation and she was sent home about a week after the procedure.Significance of the Study
This case report is important because it highlights the importance of proper follow-up after an auto accident. This patient was bleeding internally immediately afterward, as seen on the laparotomy. They were then sent home with conservative management as the abdominal hematoma started to fade. Unfortunately, it started to grow in size and wasn't seen until it was the size of a typical inguinal hernia. Fortunately, the injury was caught before the patient lost too much blood or started to have damage to internal organs. It is possible for internal bleeding to cause other organs to suffer or for the patient to lose so much blood that they could require a blood transfusion. In the future, patients should always make sure that they have appropriate follow-up following a car accident, particularly if they sustained injuries in the event. It is important for medical professionals to always remain aware of the complications that could develop after a serious injury. Patients who incur high financial costs due to an injury in an auto accident should be sure to contact an experienced personal injury attorney in Sacramento learn about their options.
Ed Smith, Sacramento Personal Injury AttorneySacramento Personal Injury Attorney
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Image Attribution: The image at the top was used with permission under the CC BY SA version 2.5, found originally on Wikimedia Commons.
Appearing in Photograph: Ed Smith, Personal Injury Attorney in Sacramento
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